scholarly journals Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP: A Retrospective Study

2019 ◽  
Author(s):  
Lin Fu ◽  
Yau Kei Chan ◽  
Junhua Li ◽  
Li Nie ◽  
Na Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Retrospective Study ◽  
Visual Field ◽  
Cataract Surgery ◽  
Final Visual Acuity ◽  
Mean Deviation ◽  
The Mean ◽  
End Stage

Abstract Background: To investigate the long term surgical outcomes of cataract surgery in severe and end glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors. Methods: A retrospective study of severe and end stage glaucoma patients who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Twenty patients (24 eyes) were included. The mean age was 64.6 ± 11.0 years and the mean followed up duration was 21.4 ± 7.3 months. The final visual acuity was significantly improved from 0.93±0.72 to 0.70±0.74, within 14 (58.3%) eyes improved, 5 (20.8%) eyes kept unchanged, and 5 (20.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with greater final visual acuity improvement (r = -0.545, r = -0.501, r = 0.521 respectively). Moreover, the final number of medications were reduced from 1.1 ± 0.9 to 0.2 ± 0.5 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 13.2 ± 3.9 (6.8-25.9) mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was reduced to 7 (29.2%) eyes compared to 11 (45.8%) eyes at baseline. Moreover, the number of eyes without the use of medications was increased from 6 (25%) preoperatively to 20 (83.3%) eyes postoperatively. Conclusions: Final visual acuity was significantly improved in the severe and end stage glaucoma patients and the number of eyes came off medications increased by 58.3% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the visual acuity changes after cataract surgery.

scholarly journals Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP:A Retrospective Study

2020 ◽  
Author(s):  
Lin Fu ◽  
Yau Kei Chan ◽  
Junhua Li ◽  
Li Nie ◽  
Na Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Final Visual Acuity ◽  
Angle Closure ◽  
Mean Deviation ◽  
Primary Angle Closure Glaucoma ◽  
The Mean ◽  
End Stage

Abstract Background: To investigate the long term surgical outcomes of cataract surgery in severe and end stage glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors.Methods: A retrospective study of primary angle closure glaucoma patients was conducted on who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Sixteen patients (19 eyes) were included. The mean age was 64.89 ± 11.68 years and the mean followed up duration was 21.89 ± 7.85 months. The final visual acuity was significantly improved from 0.69 ± 0.55 to 0.46 ± 0.52 logMAR , within 12 (63.2%) eyes improved, 4 (21.1%) eyes kept unchanged, and 3 (15.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with better final visual acuity (r = -0.511, r = -0.493, r = 0.537 respectively). Moreover, the final number of medications were reduced from 1.26 ± 0.99 to 0.26 ± 0.56 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 14.48 ± 3.74 mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was decreased to 6 (31.6%) eyes compared to 10 (52.6%) eyes at baseline. Moreover, the number of eyes free of medications was increased from 4 (21.1%) preoperatively to 15 (78.9%) eyes postoperatively.Conclusions: Final visual acuity was significantly improved in the severe and end stage primary angle closure glaucoma patients and the number of eyes came off medications increased by 57.8% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the final visual acuity after cataract surgery.

scholarly journals Real-world efficacy of the Hydrus microstent in Black and Afro-Latinx patients with glaucoma: a retrospective study

2020 ◽  
Vol 12 ◽  
pp. 251584142096431
Author(s):  
Daniel Laroche ◽  
Gideon Nkrumah ◽  
Chester Ng
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Visual Field ◽  
Cataract Surgery ◽  
Field Test ◽  
Real World ◽  
Common Adverse Effect ◽  
Mean Deviation ◽  
Visual Field Test ◽  
Phacoemulsification Cataract Surgery

Purpose: The purpose was to determine the real-world efficacy of phacoemulsification cataract surgery and Hydrus microstent in Black and Afro-Latinx patients with glaucoma. Methods: A retrospective noncomparative single-center study of 76 Black and Afro-Latinx patients with glaucoma who underwent phacoemulsification cataract surgery and Hydrus microstent placement for treatment of glaucoma at single practice. Investigated parameters were intraocular pressure (IOP), number of medications, mean deviation on visual field test, and visual acuity. Patients were also subgrouped into mild, moderate, and advance glaucoma for further analysis. Results: We reviewed a total of 76 patients who had 6 months of follow up in the study. The mean number of medications decreased significantly from 2.6 ± 1.5 preoperatively to 0.72 ± 1.4 in 6 months ( p < 0.0010), while IOP decreased from 14.7 ± 3.7 to 13.9 ± 4.3 ( p = 0.25). At 6 months, 55 patients (74%) of all patients were medication free ( n = 27, 84.4% mild glaucoma; n = 17, 70.8% moderate glaucoma; n = 10, 50% advance glaucoma). There was significant improvement in visual acuity ( p < 0.00010) and stabilization of mean deviation on visual field test (baseline −9.2; 6 months −9.1; p = 0.22). The most common adverse effect was a transient IOP spike and transient corneal edema ( n = 6, 7.9%; n = 6, 7.9%, respectively) with spontaneous resolution in all cases. No sight-threatening complications were reported at 6 months. Conclusion/clinical relevance: This 6-month retrospective study demonstrated the efficacy of phacoemulsification cataract surgery and Hydrus microstent in reducing the medication burden while maintaining lower IOP in Black and Afro-Latinx patients with glaucoma.

Relationship between mean follow-up intraocular pressure, rates of visual field progression and current target intraocular pressure guidelines

2020 ◽  
pp. bjophthalmol-2020-317406
Author(s):  
Bruna Melchior ◽  
Carlos Gustavo De Moraes ◽  
Jayter S Paula ◽  
George A Cioffi ◽  
Christopher A Girkin ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Treatment Guidelines ◽  
Evaluation Study ◽  
Mean Deviation ◽  
Racial Groups ◽  
Current Guideline ◽  
Registration Number ◽  
The Mean

AimsTo investigate if eyes presenting intraocular pressure (IOP) within the limits of current guideline-driven target IOP indeed experience slow rates of glaucomatous visual field (VF) progression.MethodsA total of 8598 24-2 VF tests from 603 eyes from the African Descent and Glaucoma Evaluation Study with manifest glaucoma were included. The sample was split into three groups based on baseline VF mean deviation (MD): G1 (better than −5.0 dB), G2 (−5.0 to −10 dB) and G3 (worse than −10 dB). We investigated the relationship between existing target IOP guidelines and rates of MD progression in these groups.ResultsFor stable eyes, the medians and IQR of the mean follow-up IOP were G1=15.0 mmHg (IQR: 13.1 to 17.7), G2=13.2 mmHg (IQR: 11.6 to 14.3) and G3=11.9 mmHg (IQR: 10.1 to 13.8) (p<0.01). When considering the mean follow-up IOP within the limits proposed by current guidelines, the median MD slopes were: −0.20 dB/y (IQR: −0.43 to −0.02) for G1<21 mmHg, −0.19 dB/y (IQR: −0.51 to −0.01) for G2<18 mmHg and −0.15 dB/y (IQR: −0.47 to 0.05) for G3<15 mmHg (p=0.63). There were no significant differences between racial groups.ConclusionIn a sample of patients with manifest glaucoma, despite substantial variability between eyes, adherence to treatment guidelines helped slow the rates of global VF progression at various stages of disease.Trial registration numberclinicaltrials.gov Identifier: NCT00221923.

scholarly journals Corneal Higher-Order Aberrations after Microhook ab Interno Trabeculotomy and Goniotomy with the Kahook Dual Blade: Preliminary Early 3-Month Results

2021 ◽  
Vol 10 (18) ◽  
pp. 4115
Author(s):  
Hiromitsu Onoe ◽  
Kazuyuki Hirooka ◽  
Hideaki Okumichi ◽  
Yumiko Murakami ◽  
Yoshiaki Kiuchi
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Retrospective Study ◽  
Cataract Surgery ◽  
Higher Order ◽  
Higher Order Aberrations ◽  
Postoperative Changes ◽  
The Mean ◽  
Kahook Dual Blade ◽  
Ab Interno

We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total of 45 eyes underwent μLOT-Phaco and KDB-Phaco (LOT-Phaco) procedures, with 21 eyes that underwent cataract surgery alone used as controls. Visual acuity and corneal HOAs, coma-like aberrations, and spherical-like aberrations were analyzed before and at 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence HOAs were evaluated. No significant postoperative changes were noted for corneal HOAs, coma-like aberrations, and spherical-like aberrations after cataract surgery alone. The mean corneal HOAs, coma-like aberrations, and spherical-like aberrations were 0.222 ± 0.115 μm, 0.203 ± 0.113 μm, and 0.084 ± 0.043 μm at baseline and 0.326 ± 0.195 μm (p < 0.001), 0.302 ± 0.289 μm (p = 0.03), and 0.150 ± 0.115 μm (p < 0.001) at 3 months after LOT-Phaco, respectively. Results of the analysis for risk factors suggested that a longer incision in Schlemm’s canal could influence corneal HOAs, coma-like aberrations, and spherical-like aberrations after LOT-Phaco. Although no significant postoperative changes were observed in corneal HOAs and coma-like or spherical-like aberrations after cataract surgery alone, a significant increase in corneal HOAs and coma-like or spherical-like aberrations remained after the LOT-Phaco procedure.

Transscleral Red Laser Cyclophotocoagulation for the Treatment of Therapy-Resistant Inflammatory Glaucoma

2007 ◽  
Vol 17 (4) ◽  
pp. 550-556 ◽  
Author(s):  
P.M. Puska ◽  
A.H.A. Tarkkanen
Keyword(s):  
Intraocular Pressure ◽  
Retrospective Study ◽  
Diode Laser ◽  
Laser Power ◽  
Application Time ◽  
Chronic Uveitis ◽  
Phthisis Bulbi ◽  
The Mean

Purpose To evaluate in a retrospective study the long-term usefulness of red 647 nm krypton and 670 nm diode laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy-resistant inflammatory glaucoma. Methods The authors treated 48 eyes of 38 consecutive patients (mean age 36.8 years, range 6–81 years) with therapy-resistant inflammatory glaucoma secondary to chronic uveitis (45/48), chronic scleritis (1/48), or combined scleritis with keratouveitis (2/48) using transscleral red 647 nm Krypton or 670 nm Diode laser. All eyes had failed maximum tolerated medical therapy and 19/48 (40%) eyes also previous antiglaucoma surgery. Laser power at the scleral surface was 0.35 to 0.45 W and the application time 10 seconds each. The follow-up was 42.8± 40.0 (range 2–145) months. Results The mean preoperative intraocular pressure (IOP) of 35.6±8.1 mmHg fell to 6–21 mmHg level in 75% after one or repeated CPC. Among adult patients this was achieved in 85%, among children in 54%. More than one treatment was needed in 52%. No cases of hypotony, phthisis bulbi, or other devastating complications occurred. Conclusions Transscleral CPC using red 647 nm krypton or 670 nm diode laser is an effective and well-tolerated procedure for the treatment of therapy-resistant inflammatory glaucoma in adults. CPC can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken

scholarly journals Pediatric Traumatic Cataracts : 10 Year-experience of a Tertiary Referral Center 

2021 ◽  
Author(s):  
Nesrin Tutas Gunaydın ◽  
Ayse Aydın Oral
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Final Visual Acuity ◽  
Close Monitoring ◽  
Iol Implantation ◽  
Tertiary Referral Center ◽  
Corrected Distance Visual Acuity ◽  
The Mean ◽  
Visual Results ◽  
Trauma Type

Abstract Background: To evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. Methods: Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated sex; age at trauma; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final corrected distance visual acuity (CDVA); amblyopia rate and complications. Results: In all, 61 eyes of 59 patients with cataracts after trauma, under 16 years of age, were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The CDVA was 0.7 LogMAR or better in 16.3% of the 49 eyes where the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. The evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final vision compared to eyes that did not undergo these procedures. Conclusion: Good visual results can be obtained in children with traumatic cataracts using PC and AV together with lens aspiration and IOL implantation, followed by effective amblyopia treatment and close monitoring.

scholarly journals Long-term Clinical Outcomes of Cataract Surgery in Patients with Retinitis Pigmentosa

2021 ◽  
Vol 62 (7) ◽  
pp. 931-938
Author(s):  
Ji Hyun Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Outcomes ◽  
Cystoid Macular Edema ◽  
Final Visit ◽  
Short Term ◽  
The Mean

Purpose: The long-term clinical outcomes of cataract surgery in patients with retinitis pigmentosa (RP) were evaluated. Methods: A retrospective analysis of medical records was performed for patients who were diagnosed with RP and underwent cataract surgery. Preoperative best-corrected visual acuity (BCVA) was compared with BCVA at 1 month postoperatively and at the final visit. The proportion of patients with cystoid macular edema development or aggravation after surgery was evaluated, as was the proportion of patients with intraocular lens subluxation/dislocation. For patients who underwent optical coherence tomography, factors associated with a BCVA of 0.5 or better at 1 month were analyzed. Results: In total, 133 eyes were included and the mean follow-up period was 58.7 months. The mean logarithm of minimal angle of resolution BCVA was 0.69 ± 0.65 at diagnosis. The BCVA was significantly improved to 0.51 ± 0.47 at 1 month postoperatively (p < 0.001). However, the BCVA at the final visit (0.70 ± 0.81) was similar to the baseline value (p = 1.000). Cystoid macular edema development or aggravation was noted in 8 eyes (6.0%) and intraocular lens subluxation/dislocation was noted in 4 eyes (3.0%). A subgroup analysis involving 108 eyes revealed that preoperative BCVA (p < 0.001) and ellipsoid zone status (p = 0.001) were associated with postoperative visual acuity. Conclusions: Short-term outcomes of cataract surgery in patients with RP were comparatively good. However, long-term visual deterioration was noted with disease progression. Preoperative BCVA and ellipsoid zone status are useful markers for predicting short-term visual outcomes.

scholarly journals Visual field progression 8 years after trabeculectomy in Asian eyes: results from The Singapore 5-Fluorouracil Study

2020 ◽  
Vol 104 (12) ◽  
pp. 1690-1696
Author(s):  
Bryan C H Ang ◽  
Sophia Seen ◽  
Arjunan Kumaran ◽  
John Mark Sim De Leon ◽  
Steve Kah Leng Seah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Intraocular Pressure ◽  
Visual Field ◽  
Retrospective Analysis ◽  
Outcome Measures ◽  
Multivariate Regression ◽  
Mean Deviation ◽  
Regression Analyses

Background/AimsThis work aimed to study the effect of long-term intraocular pressure (IOP) fluctuation on visual field (VF) progression 8 years post-trabeculectomy in Asian eyes.MethodsThis was a retrospective analysis of 8-year post-trabeculectomy data from The Singapore 5-Fluorouracil (5-FU) Study. VFs were analysed using Progressor software (Medisoft, Leeds, UK). Outcome measures included mean slope for VF per year, number of progressing points and mean slope for progressing points per year. Multivariate regression analyses were performed adjusting for age, gender, ethnicity, glaucoma type, intraoperative 5-FU, diabetes mellitus, hypertension, best pre-trabeculectomy VF mean deviation, post-trabeculectomy mean IOP, IOP reduction and IOP fluctuation (SD of IOPs at 6-monthly timepoints).Results127 (52.3%) subjects completed 8-year follow-up with ≥5 reliable VFs and ≥8 6-monthly IOP measurements. Mean age was 61.8±9.6 years. Post-operatively, mean IOP was 14.2±2.8 mm Hg and mean IOP fluctuation was 2.53±1.20 mm Hg. Higher IOP fluctuation was associated with greater mean slope for field (B=−0.071; p=0.013), number of progressing points (B=0.963; p=0.014) and VF progression as defined by ≥1 progressing point (OR=1.585; p=0.029). There was also a trend towards eyes with higher IOP fluctuation having ≥3 adjacent progressing points in the same hemifield (OR=1.489; p=0.055). Greater mean IOP reduction post-trabeculectomy was associated only with a lower mean slope for progressing points per year (B=−0.026; p=0.028). There was no significant effect of intra-operative 5-FU compared with placebo for all outcome measures.ConclusionIn post-trabeculectomy Asian eyes with well-controlled IOP, higher long-term IOP fluctuation may be associated with greater VF progression.

scholarly journals Visual Outcome after Manual Small Incision Cataract Surgery for Phacolytic Glaucoma

2020 ◽  
pp. 54-59
Author(s):  
Shams Mohammad Noman ◽  
M. A. Karim
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Phacolytic Glaucoma ◽  
The Mean ◽  
Expulsive Hemorrhage

Aim: To evaluate the visual outcome after manual small incision cataract surgery (MSICS) as a treatment of phacolytic glaucoma. Methods: The study included 43 patients with phacolytic glaucoma treated by manual small incision cataract surgery with intraocular lens implantation. Preoperative and postoperative visual acuity and intraocular pressure have been recorded and compared at the end of six weeks after surgery. Results: The mean preoperative intraocular pressure was 36.23 (± 10.86) mm of Hg. There were no significant intraoperative complications such as posterior capsular tear or expulsive hemorrhage. Post operative mean intraocular pressure (IOP) was 12.58 (± 3.45) mm Hg. Pre operative visual acuity in all the affected eyes were perception of light with projection of rays in all quadrant. Postoperative best corrected visual acuity was 6/6-6/18 in 27 patients (62.80%), 6/24- 6/36 in 10 patients (23.25%) and ≤ 6/60 in 6 patients (13.95%). Conclusion: Manual small incision cataract surgery is a safe and effective method of treatment for phacolytic glaucoma and the visual outcome and IOP reduction is satisfactory.

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